Standard Form 295 - Summary Subcontract Report - 2007
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1
2SUMMARY SUBCONTRACT REPORT
OMB No.: 9000-0007
(See instructions on reverse)
Expires: 03/31/2013
Public reporting burden for this collection of information is estimated to average 16.2 hours per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this
burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the FAR Secretariat (VIR), Regulatory
and Federal Assistance Division, GSA, Washington, DC 20405.
3. DATE SUBMITTED
1. CORPORATION, COMPANY OR SUBDIVISION COVERED
a. COMPANY NAME
b. STREET ADDRESS
4. REPORTING PERIOD:
YEAR
OCT 1 -
OCT 1 -
c. CITY
d. STATE e. ZIP CODE
MAR 31
SEPT 30
5. TYPE OF REPORT
2. CONTRACTOR IDENTIFICATION NUMBER
REGULAR
FINAL
REVISED
6. ADMINISTERING ACTIVITY (Please check applicable box)
ARMY
DEFENSE CONTRACT MANAGEMENT AGENCY
DOE
NAVY
NASA
OTHER FEDERAL AGENCY (Specify)
AIR FORCE
GSA
7. REPORT SUBMITTED AS (Check one)
8. TYPE OF PLAN
PRIME CONTRACTOR
INDIVIDUAL
IF PLAN IS A COMMERCIAL PLAN, SPECIFY THE
SUBCONTRACTOR
PERCENTAGE OF THE DOLLARS ON THIS REPORT
ATTRIBUTABLE TO THIS AGENCY.
COMMERCIAL PRODUCTS
BOTH
9. CONTRACTOR'S MAJOR PRODUCTS OR SERVICE LINES
a
b
CUMULATIVE FISCAL YEAR SUBCONTRACT AWARDS (Report cumulative figures for reporting period in Block 4)
PERCENT
TYPE
WHOLE DOLLARS
(To nearest tenth
of a %)
10a.
SMALL BUSINESS CONCERNS (Dollar Amount and Percent of 10c). (SEE SPECIFIC
INSTRUCTIONS)
LARGE BUSINESS CONCERNS (Dollar Amount and Percent of 10c). (SEE SPECIFIC
10b.
INSTRUCTIONS)
10c.
100.0%
TOTAL (Sum of 10a and 10b).
SMALL DISADVANTAGED BUSINESS CONCERNS (SDB)
11.
(Dollar Amount and Percent of 10c). (SEE SPECIFIC INSTRUCTIONS)
12.
WOMEN-OWNED SMALL BUSINESS (WOSB) CONCERNS (Dollar Amount and Percent of 10c).
(SEE SPECIFIC INSTRUCTIONS)
HISTORICALLY BLACK COLLEGES AND UNIVERSITIES (HBCU) AND MINORITY
13.
INSTITUTIONS (If Applicable) (Dollar Amount and Percent of 10c). (SEE SPECIFIC INSTRUCTIONS)
14.
HUBZONE SMALL BUSINESS (HUBZone SB) CONCERNS (Dollar Amount and Percent of 10c).
(SEE SPECIFIC INSTRUCTIONS)
15.
VETERAN-OWNED SMALL BUSINESS (VOSB) CONCERNS (Dollar Amount and Percent
of 10c). (SEE SPECIFIC INSTRUCTIONS)
16.
SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESS CONCERNS
(Dollar Amount and Percent of 10c). (SEE SPECIFIC INSTRUCTIONS)
17.
ALASKA NATIVE CORPORATIONS (ANCs) AND INDIAN TRIBES THAT HAVE NOT BEEN
CERTIFIED BY THE SMALL BUSINESS ADMINISTRATION AS SMALL DISADVANTAGED
BUSINESSES (Dollar Amount) (SEE SPECIFIC INSTRUCTIONS)
18.
ALASKA NATIVE CORPORATIONS (ANCs) AND INDIAN TRIBES THAT ARE NOT SMALL
BUSINESSES (Dollar Amount) (SEE SPECIFIC INSTRUCTIONS)
19. CONTRACTOR'S OFFICIAL WHO ADMINISTERS SUBCONTRACTING PROGRAM
a. NAME
b. TITLE
c. TELEPHONE NUMBER
AREA CODE NUMBER
STANDARD FORM 295
AUTHORIZED FOR LOCAL REPRODUCTION
(REV. 9/2007)
PREVIOUS EDITION IS NOT USABLE
Prescribed by GSA - FAR (48 CFR) 53.219 (b)
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